Ask the Coaches: IT Band - Hip Abductors

Published

January 1, 2003

Q: I have been battling Illiotibial Band Syndrome for several years and would like to get some advice on how to avoid it in the future. Four years ago I injured my left IT band and was out for 3 months. I had begun doing speed-work 5 months earlier and increased the intensity of my workouts just prior to the injury. Upon recovering, I did not attempt speed-work until Spring 2002, when I injured both IT bands during Week 5 of the Running Times Intermediate 10k Training program. During this week I also began doing leg weights (quad and hamstring), ironically in an effort to avoid IT band trouble. I was out (no running at all) this time for 6 months. After recovering and running for 3 months with no IT pain, I have begun doing one speed workout per week for the past 4 weeks and would like to attempt the Running Times program again. Any advice you have would be greatly appreciated!

A: The iliotibial (IT) band originates along the side of the pelvis and runs along the outside of the leg, attaching on the tibia, just below the knee. Irritation of the band is a common problem for runners, typically causing pain along the outside of the knee and sometimes on the outside of the hip. Rubbing of the IT band over the bony prominences and bursae at the knee and the hip causes the pain. The longer your stride length, such as with faster running, the greater the amount of rubbing.

Many runners with IT band inflammation have weak hip muscles. In addition to working on hamstring and quadriceps strength, you need to work on the strength of the hip abductors (muscles that move the leg out to the side), adductors (move the leg inward) and gluteal muscles. Do not increase the distance or intensity of your workouts while adding these exercises to your workout. When you have been working on strength for 3 – 4 weeks, then begin increasing workouts. Continue to work on flexibility.

Beware of your running surface. Left IT band pain is much more common than right sided pain, due to the crown in the road. Most smart runners train on the left side of the road (facing traffic). This puts greater stress on the outside of the left knee, increasing the likelihood of a problem.

Apply ice to the IT band following all workouts for at least a month or so.

Be patient; surgery is rarely needed for this problem. If there is a biomechanical problem, orthotics may be helpful.

If the problem persists, see a sports medicine specialist for further evaluation.